In today’s New York Times, Dr. Atul Gawande says we can learn from U.S. communities that deliver high-quality, lower-cost health care. Gawande and colleagues identified communities that rank among the top 25% for quality of care and in the bottom 25% for cost, and they invited health care leaders from ten of these communities to convene in the ‘other’ Washington to discuss what they are doing right.

One of those communities was nearby Everett, Wash., which includes 362-bed Providence-Everett Hospital, a multi-specialty physician group called The Everett Clinic, and the Premera Blue Cross insurance plan.

Turns out the ten communities have a few things in common. Their health care organizations are largely non-profit. Typically the needs of patients come before commercial concerns. More and more, the organizations are collecting data to measure and improve on their own performance. There is a strong primary care presence in the communities, which leaders identified as critical to efficiency. The result is a blend of collaboration and competition among various physician practices, hospitals, and insurers.

And patient satisfaction is very high in these settings.

Especially telling, I thought, was a comment from the Everett contingent: “We are doing less worse than the rest of the U.S.” Maybe something else that puts these folks at the top of the heap is their recognition that there is always room to improve.

audrey young

I'm a general internist from Seattle. My first book was What Patients Taught Me. The latest book is House of Hope and Fear, published in August 2009, and now out in paperback. For more about both books and about physician writers, please visit my website.